clinical pathway for acute copd exacerbations reduces hospital stay and readmission

Clinical pathway for acute COPD exacerbations reduces hospital stay and readmission G. Celis RN, C. Lodewijckx LN, A. Schoonis RN, M. Decramer MD, PhD Pneumology Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium BACKGROUND COPD patients have frequent hospital admissions and a longer hospital stay compared to other chronic illness. In 2000 we implemented a 10-day clinical pathway (CP) for acute COPD exacerbations. In May 2003 the duration was reduced to 8 days. The CP describes the tasks of the multidisciplinary team: medication, examinations, diet, physiotherapy, education among lifestyle modification and therapy, nursing care and discharge management. The aim of the CP is to standardise the treatment, to reduce the length of stay and to screen patients for a rehabilitation program. AIMS OF THE STUDY To explore the benefit of a clinical pathway: on the hospital stay and the readmission interval in patients hospitalized due a COPD exacerbation. METHODS A retrospective study. 68 CP patients and 94 control patients hospitalized due an COPD exacerbation during the year 2004. CONCLUSIONS Patients hospitalized for an acute COPD exacerbation and involved in a clinical pathway have a: significantly shorter duration of hospital stay significantly higher readmission interval during the first year after discharge. RESULTS The mean hospital stay for CP patients was 10.24 days (SD ± 3.940) and the control group had a mean hospital stay of 13.21 (SD ± 12.663) (p=0.034). During the first year after discharge 35.3% of the CP patients had a mean readmission interval of 160,79 days (SD ± 117.80) and 34,0% of the control group had a mean readmission interval of 94,38 days (SD ± 95.16) (p= 0.029). •Medical doctor •Nurse •Physiotherap ist •Dietician Multidisciplinary team •Social worker •Psychologist •Ergotherapist CHALLENGE To include every COPD patient hospitalized for an acute exacerbation in the critical path. Fig.2: Mean readmission interval during the first year after discharge. Fig.1: Mean hospital stay for an acute COPD exacerbation. M ean hospital stay 13,21 10,24 0 2 4 6 8 10 12 14 Control Crit.Path days Mean readm ission interval during the firstyearafterdischarge 94,38 160,79 0 20 40 60 80 100 120 140 160 180 Control Crit.Path days

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Page 1: Clinical pathway for acute COPD exacerbations reduces hospital stay and readmission

Clinical pathway for acute COPD exacerbations reduces hospital stay and readmissionG. Celis RN, C. Lodewijckx LN, A. Schoonis RN, M. Decramer MD, PhD

Pneumology Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium

BACKGROUND

COPD patients have frequent hospital admissions and a longer hospital stay compared to other chronic illness. In 2000 we implemented a 10-day clinical pathway (CP) for acute COPD exacerbations. In May 2003 the duration was reduced to 8 days. The CP describes the tasks of the multidisciplinary team: medication, examinations, diet, physiotherapy, education among lifestyle modification and therapy, nursing care and discharge management. The aim of the CP is to standardise the treatment, to reduce the length of stay and to screen patients for a rehabilitation program.

AIMS OF THE STUDY

To explore the benefit of a clinical pathway: on the hospital stay and the readmission intervalin patients hospitalized due a COPD exacerbation.

METHODS

A retrospective study. 68 CP patients and 94 control patients hospitalized due an COPD exacerbation during the year 2004.

CONCLUSIONS

Patients hospitalized for an acute COPD exacerbation and involved in a clinical pathway have a:

significantly shorter duration of hospital stay

significantly higher readmission interval during the first year after discharge.

RESULTS

The mean hospital stay for CP patients was 10.24 days (SD ± 3.940) and the control group had a mean hospital stay of 13.21 (SD ± 12.663) (p=0.034).

During the first year after discharge 35.3% of the CP patients had a mean readmission interval of 160,79 days (SD ± 117.80) and 34,0% of the control group had a mean readmission interval of 94,38 days (SD ± 95.16) (p= 0.029).

•Medical doctor

•Nurse

•Physiotherapist

•Dietician

Multidisciplinary team

•Social worker

•Psychologist

•Ergotherapist

CHALLENGE

To include every COPD patient hospitalized for an acute exacerbation in the critical path.

Fig.2: Mean readmission interval during the first year after discharge.

Fig.1: Mean hospital stay for an acute COPD exacerbation.